Provider Demographics
NPI:1427292242
Name:AYZMAN, ELINA (SLP-CCC)
Entity type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:AYZMAN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HORIZON RD
Mailing Address - Street 2:APT 1709
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6652
Mailing Address - Country:US
Mailing Address - Phone:917-952-9705
Mailing Address - Fax:
Practice Address - Street 1:225 ADELPHI ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4008
Practice Address - Country:US
Practice Address - Phone:718-834-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist